Ovarian cysts are fluid-filled sacs or pockets in an ovary or on its surface. Women have two ovaries — each about the size and shape of an almond — on each side of the uterus. Eggs (ova), which develop and mature in the ovaries, are released in monthly cycles during the childbearing years.
Many women have ovarian cysts at some time. Most ovarian cysts present little or no discomfort and are harmless. The majority disappears without treatment within a few months.
However, ovarian cysts — especially those that have ruptured — can cause serious symptoms. To protect your health, get regular pelvic exams and know the symptoms that can signal a potentially serious problem.
Most cysts don't cause symptoms and go away on their own. However, a large ovarian cyst can cause:
Seek immediate medical attention if you have:
If you have these signs and symptoms or those of shock — cold, clammy skin; rapid breathing; and lightheadedness or weakness — see a doctor right away.
Most ovarian cysts develop as a result of your menstrual cycle (functional cysts). Other types of cysts are much less common.
Your ovaries normally grow cyst-like structures called follicles each month. Follicles produce the hormones estrogen and progesterone and release an egg when you ovulate.
If a normal monthly follicle keeps growing, it's known as a functional cyst. There are two types of functional cysts:
Functional cysts are usually harmless, rarely cause pain, and often disappear on their own within two or three menstrual cycles.
Types of cysts not related to the normal function of your menstrual cycle include:
Dermoid cysts and cystadenomas can become large, causing the ovary to move out of position. This increases the chance of painful twisting of your ovary, called ovarian torsion. Ovarian torsion may also result in decreasing or stopping blood flow to the ovary.
Your risk of developing an ovarian cyst is heightened by:
Some women develop less common types of cysts that a doctor finds during a pelvic exam. Cystic ovarian masses that develop after menopause might be cancerous (malignant). That's why it's important to have regular pelvic exams.
Infrequent complications associated with ovarian cysts include:
Although there's no way to prevent ovarian cysts, regular pelvic exams help ensure that changes in your ovaries are diagnosed as early as possible. Be alert to changes in your monthly cycle, including unusual menstrual symptoms, especially ones that persist for more than a few cycles. Talk to your doctor about changes that concern you.
A cyst on your ovary can be found during a pelvic exam. Depending on its size and whether it's fluid filled, solid or mixed, your doctor likely will recommend tests to determine its type and whether you need treatment. Possible tests include:
CA 125 blood test. Blood levels of a protein called cancer antigen 125 (CA 125) often are elevated in women with ovarian cancer. If your cyst is partially solid and you're at high risk of ovarian cancer, your doctor might order this test.
Elevated CA 125 levels can also occur in noncancerous conditions, such as endometriosis, uterine fibroids and pelvic inflammatory disease.
Treatment depends on your age, the type and size of your cyst, and your symptoms. Your doctor might suggest:
Watchful waiting. In many cases you can wait and be re-examined to see if the cyst goes away within a few months. This is typically an option — regardless of your age — if you have no symptoms and an ultrasound shows you have a simple, small, fluid-filled cyst.
Your doctor will likely recommend that you get follow-up pelvic ultrasounds at intervals to see if your cyst changes in size.
Surgery. Your doctor might suggest removing a cyst that is large, doesn't look like a functional cyst, is growing, continues through two or three menstrual cycles, or causes pain.
Some cysts can be removed without removing the ovary (ovarian cystectomy). In some cases, your doctor might suggest removing the affected ovary and leaving the other intact (oophorectomy).
If a cystic mass is cancerous, your doctor will likely refer you to a gynecologic cancer specialist. You might need to have your uterus, ovaries and fallopian tubes removed (total hysterectomy) and possibly chemotherapy or radiation. Your doctor is also likely to recommend surgery when an ovarian cyst develops after menopause.
You're likely to start by seeing your primary care provider or a doctor who specializes in conditions that affect women (gynecologist).
Make a list of:
Take a family member or friend with you, if possible, to help you remember the information you're given.
Questions to ask your doctor include:
Don't hesitate to ask other questions.
Questions your doctor might ask include:
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